Tracheal tube assembly



Aug. 8, 1967 F. STEBLETON 3 15 TRACHEAL TUBE ASSEMBLY Filed Sept. 11, 1964 INVENTOR. LEO F. STEBLETO/V BY mo 5 Ram/MM firm/w United States Patent 3,334,631 TRACHEAL TUBE ASSEMBLY Leo F. Stebleton, Midland, Mich., assignor to Dow Corning Corporation, Midland, Mich., a corporation of Michigan Filed Sept. 11, 1964, Ser. No. 395,675 2 Claims. '(Cl. 128-351) ABSTRACT OF THE DISCLOSURE An improved tracheotomy tube device including an inner and outer tube preferably made of silicone rubber. Those two tubes are connected in use by a snap arrangement which allows the inner tube to be withdrawn from the patient with a minimum amount of discomfort to him. The snap arrangement includes an oblong shaped opening into the proximal end of the outer tube, a flange on the proximal end of the inner tube, a collar formed on the inner tube near its proximal end, and a ring groove of enlarged diameter formed in the inside surface of the proximal portion of the outer tube.

The present invention relates to the field of surgical appliances, and more particularly, to tracheal tube assemblies and the like.

Tracheal tubes are utilized in situations wherein the normal respiratory functions of the nose or throat have been impaired. It is quite common, in the event of such an occurence, for the use of a surgical procedure termed tracheotomy; that is, for an incision to be made in the throat and a tracheal tube assembly inserted through the opening and into the trachea. This procedure allows communication between the trachea, or windpipe, and the ambient air so that the impaired areas of the nose or throat are bypassed in the respiratory function.

Various types of tracheal devices have heretofore been used for this purpose. Most recently the most common type of device for providing passage to the trachea has been a metallic tube which is either of solid silver or silver plated material. Devices of this type are generally rigid, having a predetermined curvature, and have a flange or flanges at their outermost ends which are designed to be flush against the exterior surface of the throat. An obturator has been provided to close the tube during insertion.

Several disadvantages have been inherent in these rigid prior art devices. The rigidity of the tube causes discomfort and tissue irritation, and also necessitates stocking a variety of tubes having different bending radii and different lengths. Silver is expensive. The tubes are relatively heavy, thereby adding to the discomfort. The patients movements are severely restricted. The rigid tubes are subject to damage and become tarnished and unsightly.

Realizing these deficiencies, prior workers in the art have suggested making the tracheal tubes of different materials. The choice of materials has been severely limited, however, by such factors as rejection of many materials by human tissue, necessity for sterilization; and attack and corrosion of the materials by body secretions. Nevertheless, several types of nonmetallic materials, such as nylon, polyethylene, and polystyrene, and flexible metal devices have been proposed. Each of these materials have still suffered from some of the prior art disadvantages.

The primary object of the present invention, therefore, is to provide an improved tracheotomy tube structure which will be free from the aforementioned and other disadvantages of prior devices of this type.

More particularly, it is an object of the present invention to provide a tracheotomy tube device which will cause a minimum of discomfort to the wearer, but which is inexpensively manufactured, easily inserted, and easily cleaned.

Another object is to provide an improved tracheotomy tube structure which affords freedom of motion of the wearers head and neck, and which is inert to the human body.

In accordance with these and other objects, there is provided by the present invention, a tracheotomy tube structure made of silicone rubber. Silicone rubber is inert to the human body. Provision is made for an inner tube and an outer tube as is conventional in such devices, but both tubes are by the nature of the silicone rubber so flexible that any one shape will bend to fit a number of different curvatures and the head and neck movements of the wearer are virtually unrestricted. Since the material is soft and inexpensive, compared to many prior art materials, the ends of the tubes may be cut to the desired length before insertion and the excess discarded. The two tubes are connected in use by an easily releasable snap arrangement and the device may also be molded to form a releasable seal between the inner and outer tubes. There is further provided an obturator of the same material which is also flexible and easily cut to the desired length. If desired, the device may be tinted to match the wearers skin color. A further advantage is the nonwettable nature of silicones which helps to prevent clogging of the tube by mucous.

Other objects and many more attendant advantages will become obvious to those skilled in the art by reading the following detailed description in connection with the accompanying drawings wherein:

FIG. 1 is a view in perspective showing the tracheotomy tube assembly of the present invention in place on the throat of a patient;

FIG. 2 is a side view in elevation of the inner tube of the device shown in FIG. 1;

FIG. 3 is a side view in elevation of the outer tube of the device shown in FIG. 1;

FIG. 4 is an end view in elevation of the outer tube shown in FIG. 3;

FIG. 5 is a fragmentary view, partly in cross-section, showing the manner in which the inner tube is withdrawn from the outer tube;

FIG. 6 is a fragmentary view, partly in cross-section, of the outermost portions of the inner and outer tubes, the inner tube being in a position slightly withdrawn from its normal operational position; and

FIG. 7 is a side elevational view, partly in cross-section of an obturator made in accordance with the present invention in position for inserting the outer tube into the trachea of a patient.

Referring now to the drawings wherein like reference numerals designate like or corresponding parts throughout the figures thereof, there is shown in FIG. 1, a tracheal tube assembly comprising an outer tube 11 of silicone rubber material which is inserted into an incision through the patients throat and into the trachea. The tube 11 may be secured in place by means of a neckband connected to a flange 12, which is formed on the outermost proximal portion of the tube 11 (as may be seen in greater detail in FIG. 3) and is adapted to rest against the throat.

As may be seen most clearly, in FIG. 2, an inner tube 13, sometimes known as a cleanout tube and also made from silicone rubber, is provided for insertion into the outer tube 11. The inner tube 13 has an outer diameter which is slightly less than the internal diameter of the outer tube 11 and has provided on its outermost end a flange or gripping portion 14. As may be seen in FIGS. 3 and 4, a ring groove 16 of enlarged diameter is formed in the inside surface of the proximal portion of the outer tube 11 and is adapted to be engaged by a collar 17 which is formed on the inner tube 13 in a corresponding position.

The outer opening 18 into the outer tube 11 is preferably formed in an oblong configuration with one diameter which is substantially the same as the enlarged diameter of the ring groove 16, while the diameter of the opening 18 which is perpendicular to the diameter which was first considered is made considerably smaller, so that it will engage the outermost surfaces of the collar 17 of the inner tube 13.

A consideration of FIGS. 5 and 6 will show the reasons for providing the opening 18 with an oblong shape. The inner tube 13 is designed for removal and cleaning while the outer tube 11, once inserted into a patient, remains in place. As the inner tube is inserted into the outer tube the collar 17 on the inner tube, being resilient, slides through the opening 18 and snaps into the larger diameter ring groove portion 16 formed in the inner surface of the outer tube. The partially circumferential flanges which form the smaller dimension of the opening 18 serve to hold the inner tube in place and in sealing relationship with the ring groove 16 by bearing against the outer portions of the collar 17. In order to remove the inner tube the flanged gripping portion 14 is squeezed between thumb and finger as shown in FIG. 5, which, due to the resilient nature of the material causes the collar 17 to be pulled back on opposite sides to clear the narrow portions of the opening 18 and the tube 13 is thereby allowed to be withdrawn with a minimum of discomfort to the patient. While the opening 18 may be made with a uniform small diameter, the pulling and snapping effect of the resilient collar 17 being pulled through the small opening is likely to be uncomfortable at best, and could tend to cause inflammation of the tissues through which the outer tube passes.

As shown in FIG. 7, there may also be provided an obturator of solid silicone rubber for insertion of the outer tube 11 after the incision has been made. The obturator comprises a solid flexible rod 19 to which there are attached a handle or knob 21, and a collar 22, which prevents the obturator from being inserted too far into the tube. As is conventional, the obturator is of a slightly smaller diameter than the inner diameter of the outer tube and serves to facilitate introduction of the tube into its proper place without blockage.

Each of the tubes 11 and 13 and the rod 19 of the obturator are of flexible silicone rubber material and have a preset curvature and length corresponding to the curvature and length required for the usual patient. By virtue of the flexibility of the material the device will bend during insertion to conform to the actual curvature needed. If a shorter tube is indicated, the tubes and obturator may be shortened before insertion by cutting the distal ends to the desired length, thus eliminating the necessity of stocking a large variety of shapes and sizes.

An added advantage of the use of silicone rubber for tracheal devices is the nonwettable nature of the material. Accordingly, the mucous collection normally inherent in such devices is lessened considerably thereby reducing clogging of the inner tube.

If desired, the material of the device may be tinted to flesh tones in order to make it less noticeable.

Many modifications and variations of the above described embodiment of the invention will be obvious to those skilled in the art. Accordingly, within the scope of the appended claims, the invention may be practiced otherwise than as specifically described.

That which is claimed is:

1. A tracheal device comprising:

a flexible outer tube having predetermined curvature and adapted to be inserted into the trachea of the user through an incision in the throat, and

a flexible inner tube having an external diameter slightly smaller than the internal diameter of the outer tube and being freely insertable into the outer tube;

the outer tube including a transversely extending flange at its proximal end, which flange is adapted to bear against the skin of the user around the incision,

the outer tube including further a ring groove located near its proximal end opening, the diameter of that ring groove being larger than the inside diameter of that tube,

said inner tube including a flexible collar of enlarged diameter on its outer surface located to mate with the ring grooveof the outer tube, when the inner tube is inserted its maximum distance into the outer tube,

the outer tube including further an oblong configuration forming the proximal end opening into that tube, which oblong configuration has a first diameter substantially the same as the enlarged diameter of the ring groove, and a second diameter, perpendicular to the first, considerably smaller than the enlarged diameter of the ring groove, and adapted to hold the collar of the inner tube in place in the ring groove, and

the inner tube including further a transversely extending flange at its proximal extremity, which flange is flexible and manually grippable and located in close proximity to the flexible collar and which flange when squeezed in a predetermined direction contracts the collar and permits withdrawal of the inner tube from the outer tube.

2. A tracheal device as defined in claim 1 wherein: both the inner and outer tubes are made of silicone rubber.

References Cited UNITED STATES PATENTS 2,765,792 10/1956 Nichols 128-351 2,786,469 3/1957 Cohen l28351 3,088,466 5/ 1963 Nichols 12835 1 3,111,125 11/1963 Schulte 128350 OTHER REFERENCES The Bulletin (Dow Corning Center for Medical Research), volume 4, #2, April 1962, page 6.

The Bulletin (Dow Corning Center for Medical Research), volume 4, 2, April 1963, pages 5 and 6.

RICHARD A. GA'UDET, Primary Examiner.

D. L. TRULUCK, Examiner. 

1. A TRACHEAL DEVICE COMPRISING: A FLEXIBLE OUTER TUBE HAVING PREDETERMINED CURVATURE AND ADAPTED TO BE INSERTED INTO THE TRACHEA OF THE USER THROUGH AN INCISION IN THE THROAT, AND A FLEXIBLE INNER TUBE HAVING AN EXTERNAL DIAMETER SLIGHTLY SMALLER THAN THE INTERNAL DIAMETER OF THE OUTER TUBE AND BEING FREELY INSERTABLE INTO THE OUTER TUBE; THE OUTER TUBE INCLUDING A TRANSVERSELY EXTENDING FLANGE AT ITS PROXIMAL END, WHICH FLANGE IS ADAPTED TO BEAR AGAINST THE SKIN OF THE USER AROUND THE INCISION, THE OUTER TUBE INCLUDING FURTHER A RING GROOVE LOCATED NEAR ITS PROXIMAL END OPENING, THE DIAMETER OF THAT RING GROOVE BEING LARGER THAN THE INSIDE DIAMETER OF THAT TUBE, SAID INNER TUBE INCLUDING A FLEXIBLE COLLAR OF ENLARGED DIAMETER ON ITS OUTER SURFACE LOCATED TO MATE WITH THE RING GROOVE OF THE OUTER TUBE, WHEN THE INNER TUBE IS INSERTED ITS MAXIMUM DISTANCE INTO THE OUTER TUBE, THE OUTER TUBE INCLUDING FURTHER AN OBLONG CONFIGURATION FORMING THE PROXIMAL END OPENING INTO THAT TUBE, WHICH OBLONG CONFIGURATION HAS A FIRST DIAMETER SUBSTANTIALLY THE SAME AS THE ENLARGED DIAMETER OF THE RING GROOVE, AND A SECOND DIAMETER, PERPENDICULAR TO THE FIRST, CONSIDERABLY SMALLER THAN THE ENLARGED DIAMETER OF THE RING GROOVE, AND ADAPTED TO HOLD THE COLLAR OF THE INNER TUBE IN PLACE IN THE RING GROOVE, AND THE INNER TUBE INCLUDING FURTHER A TRANSVERSELY EXTENDING FLANGE AT ITS PROXIMAL EXTREMITY, WHICH FLANGE IS FLEXIBLE AND MANUALLY GRIPPABLE AND LOCATED IN CLOSE PROXIMITY TO THE FLEXIBLE COLLAR AND WHICH FLANGE WHEN SQUEEZED IN A PREDETERMINED DIRECTION CONTRACTS THE COLLAR AND PERMITS WITHDRAWAL OF THE INNER TUBE FROM OUTER TUBE. 